Medication review, polypharmacy and deprescribing: Results of a pilot scoping exercise in undergraduate and postgraduate education

Background: As part of tackling polypharmacy, effective medication review and safe deprescribing are key to World Health Organisation’s (WHO) 3rd Global Patient Safety Challenge. There is little information about whether this occurs consistently in pharmacy and medicine courses in England. Objective: To create a snapshot of medication review, polypharmacy and deprescribing educational activity in a small number of university courses for medicines, pharmacy and non-medical prescribing. Method: The authors undertook a pilot scoping exercise by emailing colleagues in schools of pharmacy and medicine across England about course inclusion of medication review and deprescribing. 11 universities, describing 17 programmes, responded (eight undergraduate pharmacy, four undergraduate medicine, four postgraduate medicine, one non-medical prescribing course). Data were categorised as: programme content, tools to support deprescribing, learning outcomes, and future intentions for deprescribing teaching. Results: The results suggested variation in what was being taught. Conclusion: In order to address both national and international agenda, the authors suggest that inclusion of training in this area and consistency of curricula are crucial to adequately equipping our future workforce to be fit for purpose.

1 Osler and the fellowship of postgraduate medicine

Sir William Osler’s legacy lives on through the Fellowship of Postgraduate Medicine (FPM). Osler was in 1911 founding President both of the Postgraduate Medical Association and on 1981 of the Inter-allied Fellowship of Medicine. These societies merged later in 1919, with Osler as President until his death at the end of that year. This joint organization was initially called the Fellowship of Medicine and Post-Graduate Medical Association and continues to this day as the Fellowship of Postgraduate Medicine. In the 1880s, in his role as medical leader in North America, Osler pioneered hospital residency programmes for junior trainee doctors. As Regius Professor of medicine in Oxford from 1905, Osler wished early postgraduate teaching in the UK, and in London in particular, to include access to ‘the wealth of material at all the hospitals’. He also saw medical societies as important for providing reliable continuous medical develop for senior doctors.Under Osler’s leadership, the Fellowship of Medicine responded to demand for postgraduate civilian medical training after the First World War, supported by a general committee of 73 senior medical figures, with representatives from the British Army Medical Service, Medical Services of the Dominions of the United Kingdom, of America and of the British Colleges and major medical Schools. Some fifty general and specialist hospitals were initially affiliated with the Fellowship, which provided sustained support of postgraduate training well into the 1920s, including publication of a weekly bulletin of clinics, ward rounds, special lectures and organized training courses for men and women of all nationalities. In 1925, in response to expanding interest in postgraduate education, the Fellowship developed the bulletin into the Postgraduate Medical Journal, which continues as a monthly international publication. Stimulated by discussions at meetings of the FPM, through its Fellows, the FPM was influential in encouraging London and regional teaching hospitals to develop and maintain postgraduate training courses. The FPM and its Fellows also were important in supporting the creation of a purely postgraduate medical school, which was eventually founded at the Hammersmith Hospital in West London as the British, then Royal Postgraduate Medical School.At the end of the Second World War, there was a major development in provision of postgraduate medical education with the founding in 1945 of the British Postgraduate Medical Federation, which was supported by government, the University Grants Committee and the universities. There was also a marked post-war increase in general provision of postgraduate training at individual hospitals and within the medical Royal Colleges. Postgraduate Centres were established at many hospitals.Nonetheless the FPM continued some involvement in postgraduate courses until 1975. Since then the FPM has maintained a national and international role in postgraduate education through its journals, the Postgraduate Medical Journal and Health Policy and Technology (founded in 2012) and by affiliations with other organisations and institutes.Osler was an avid supporter of engagement between medicine and the humanities, chiding humanists for ignorance of modern science and fellow scientists for neglecting the humanities. The FPM has over much of the past decade supported this theme of Osler by being a major patron of the Hippocrates Prize for Poetry and Medicine, which has achieved significant international interest, with over 10,000 entries from over 70 countries.

A Scientometric Study of the “Journal of Postgraduate Medicine”

The subject of this paper is the Scientometric analysis of 601articles printed in “Journal of Postgraduate Medicine” from 2013 to 2017. The study focuses on numerous aspects of the journal like the year wise distribution of articles, annual rate of growth, authorship pattern, authorship productivity,degreeof collaboration, and collaborative index. The maximum number of 153(25.5%) papers were published in 2017 and the minimum of 98(16.3%) in 2013. The study shows that the maximum of 201(33.4%) out of 601articles are contributed by more than four authors and the single author contribution constitute the minimum number 95(15.5%). It is analyzed that minimum AAPP as 2.12 with maximum productivity per author is 0.47 in the year 2017and maximum AAPP as 6.25 with minimum productivity per author is 0.15 within the year 2013. Overall the average degree of collaboration was 0.84, and the average collaborative index was 3.6.The range of AGR is between(31.9%) and (56.1%). This study might fecilitate people who would like to map the scientometric patterns of journals or establishments or individual.